How do you boost a positive parametrial margin in endometrial cancer after TAH BSO?
Do you use brachytherapy or external beam? What prescription / dose / regimen do you typically use? What if there is small bowel hanging into the field near the cuff?
Community PollStarted
What dose would you treat a positive parametrial margin to with no gross disease on imaging?
218 physicians have voted
Join Mednetto vote and see how they answered.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on
For a patient with a positive margin, we would first want to image post-operatively to make sure there isn't any gross disease. MRI is most helpful for this. The goal for the dose would be to treat this region to about 60 Gy. We would initially treat the pelvis to 45 Gy with an integrated boost at t...
Join for free or sign in to see the full answer
Mednet Member
Radiation Oncology · Stanford University
Answered on
Agree with the above explanation. If the patient is receiving VBT, this will not contribute an appreciable dose to the pelvic sidewall/parametria.
As a teaching point, we consider the brachytherapy dose in combination with EBRT dose for definitive treatment of cervical cancer with parametrial invol...
Join for free or sign in to see the full answer